The Director of Public Health             Annual Report 2015/16

Social connectedness

Why is Social Connectedness important for healthy ageing?

People can feel lonely when we feel our social relationships do not match our own expectations for social relations and this may vary for each of us.  One person can feel lonely while being surrounded by family and friends, while another with few social contacts may not feel alone at all.

Evidence is now clear that our social relationships are critical for us to age well. Studies have found that older people who have close connections and relationships not only live longer, but also cope better with health problems and are less likely to experience depression.  Feeling lonely for long periods of time is as bad for our health as high blood pressure, lack of exercise, obesity or smoking and can actually accelerate the ageing process in people aged over 60.

 

Good quality social relationships benefit both individuals and the wider community. Problems arising from isolation and loneliness lead to an increased use of health and social care services as well as a higher number of GP consultations and emergency admissions to hospital; adding significant pressures to available resources.

 

Taking action to increase the number and quality of social relationships is, therefore, important for people to age well. Research shows that people with adequate social relationships have a 50% greater likelihood of survival compared to those with poor or insufficient social relationships.  They are also more likely to engage in voluntary activities and provide informal care which in a virtuous cycle, can go on to increase social connectedness and alleviate pressure on the health and care system.

 

If people are no longer part of everyday society they can also start to become separated from the values prevailing in that society; values that are essential for integration and stability. Therefore, the social isolation of older people can not only deprive the community from an important source of knowledge and experience but it can also play a role in the weakening of social bonds and solidarity within communities.

 

Life changes can impact on the number and quality of our social and community networks and may change our perception of them, affecting isolation and loneliness as shown in figure 1 below. As we age we can become more likely to experience these life changes and more vulnerable to their impact on the quality of our lives.

Figure 1 - Changes impacting on social connectedness

What is the position in Dudley?

Unfortunately social isolation affects a large number of older people. Studies have estimated that 14% of men and 11% of women aged 50 and over experience a moderate to high degree of social isolation. Applying these figures to Dudley suggests that 8,000 men and 7,000 women aged 50 and over are socially isolated.  As the proportion of the population aged 65 and over increases, it is likely that unless action is taken to prevent it, the absolute numbers of isolated people will continue to rise.

A survey undertaken by the Age Alliance investigated the experience of loneliness and isolation amongst older people in Dudley in 2015, and the results were consistent with national research. Thirteen percent of the respondents said they felt lonely often, which is equivalent to about 10,000 people aged 60 and over. See link to the report here - Loneliness and Isolation Report

  1. Being a carer
  2. Changed life patterns (including bereavement)
  3. Feeling frightened in the locality
  4. People living in care homes or sheltered housing feeling lonely despite all care needs being met
  5. Lack of whole community awareness of those who may be lonely
  6. Effects of changing physical health
  7. Lack of transport

Eleven per cent did not feel they have someone to turn to when they were lonely, which equates to around 8,000 people aged 60 and over in Dudley.  People who did have support received it from a wide range of sources including family, friends, neighbours, networks and technologies (such as computers, the internet). People reported being put off seeking support because they do not want to worry or bother others, they perceive that others are too busy, or they feel they are intruding.

When asked about what was important to them about social connectedness, older people in Dudley identified the following shown in the word cloud in figure 2 below.

What more needs to be done?

An absence of positive images of older people, stereotypes and sadly even age discrimination can act as barriers to older people connecting with others in town centres and the community, so that older people do not feel welcome in certain places. Work with older people in Manchester found that one in five people aged 65 and older in Manchester had experienced age discrimination in the previous year. In the next chapter we will focus on some of the ways that age-friendly environments can be designed(1).

Additional opportunities to present positive images of older people, challenge stereotypes and build social connectedness into the way services are delivered should also be taken by partners in Dudley.  These should include facilitating relationships between the generations so that more people from different generations can get together in purposeful activities and share their knowledge and skills, for the benefit of the whole community.

The Campaign to End Loneliness and Age UK have identified best practice in the area of reducing loneliness in later life(2). This is summarised in figure 3.

 

The interventions have been grouped to address five challenges:

  1. Reach lonely individuals
  2. Understand the nature of an individual’s loneliness and developing a personalised response
  3. Support lonely individuals to access appropriate support
  4. Put in place mechanisms that enable social connectedness in communities (structural enablers)
  5. Deliver interventions to reduce social isolation

Figure 3 - Interventions to address loneliness

Personally tailored programmes such as Time for Life based in Devon can provide support for older people to connect with their community, while at the same time being sensitive to the damaging effect that loneliness can have on confidence and ability to engage(3). These programmes connect lonely people with others in their community that they can develop trusting relationships with and who can support the achievement of specific goals. This type of personalised response to loneliness is important as loneliness is based on our perception of the value of different social relationships and therefore we need to identify the lonely person and respond to their individual needs. We anticipate that the community asset mapping currently underway in Dudley will provide intelligence to support and enable this type of approach.

There are also older people that may require more intensive additional support to overcome their loneliness, and finding and reaching them is important for healthy ageing. Routinely available data on the risk factors for loneliness have been used to target individuals or households in Cheshire(4).

 

What is already available in Dudley to reduce social isolation and loneliness?

1. Carers support

Social isolation can be a particular concern for carers. Of the six million carers in the UK around half are aged 50 and over and 1.5 million are over the age of 60.

  • 8 in 10 (83%) carers have felt lonely or socially isolated as a result of their caring responsibilitiesi
  • 57% of carers have lost touch with friends and family as a result of caring and half (49%) of carers say they have experienced difficulties in their relationship with their partner because of their caring role
  • 38% of carers in full-time employment have felt isolated from other people at work because of their caring responsibilitie
  • Carers who have reached breaking point as a result of caring are twice as likely to say that they are socially isolated because they are unable to leave the house and are also more likely to have experienced depression as a result of caring

i (Carers UK, alone and caring 23/1/2015)   http://www.carersuk.org/for-professionals/policy/policy-library/alone-caring

 

In Dudley there is a thriving carer’s network that supports carers through the provision of practical information and advice, or referral to preventative and community services. Providing:

  1. Carers Peace of Mind Emergency Contact Card Scheme,
  2. Carers Assessment of needs
  3. Options Plus – Leisure card scheme
  4. Advice Line

Click here for information on the Carers Network

The Carers Alliance has been formed to bring together key stakeholders from the statutory, private and voluntary sectors and carers to provide a holistic approach to supporting carers across the borough. They have oversight of the development and implementation of the carer’s strategy and are a sounding board for discussion and consultation as well as providing an opportunity for inter-agency networking.

There are many great examples of support for carers in Dudley.

Looking After Me- a course for carers of someone with Dementia

A report by The Princess Royal Trust for Carers reveals that 70% of older carers suffer a devastating impact on their health due to their caring role.  “Always on Call, Always Concerned”

 

‘Looking after me’ encourages carers to take a look at their own health and wellbeing and realise and value their own needs. Through a 6 week programme carers are guided through a number of topics that allow them to develop their own skills to improve their wellbeing as well as signposting them to services that can support them in their caring role.  Looking after me courses are available across Dudley for all carers aged 18 and over.

Visit www.dudleyselfmanagement.org for more information.

 

The Alzheimer’s Society also provide Carer's Information Support Programme (CRISP)  - https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=1710

Looking After Me courses are available across Dudley for all carers aged 18 and over. Younger carers are supported through Spurgeons http://www.spurgeonsyc.org/dudley

 

Other great examples of services that reduce loneliness and isolation for carers are:

 

The carers amble - supporting people to stay fit and active as well as meeting other carers and receiving advice and support about services from the local healthwatch team - http://healthwatchdudley.co.uk/new-monthly-event-for-local-carers/

 

‘Tea and Chat’ was set up by Dudley CVS and the hospital Carer Coordinator with the support of Healthwatch Dudley, in a bid to identify hidden carers.  Hidden carers are people who care for a relative, friend or a loved one but don’t receive any help or support. Trained volunteers offer patients and their visitors a warm drink, a friendly chat and the chance to find out more about the help, support or benefits that carers can tap into. http://healthwatchdudley.co.uk/carers-rights-day-marked-with-new-hospital-tea-and-chat-service/

Above - Carers Amble

Key messages

  • Loneliness is common in older age
  • We estimate that 8,000 men and 7,000 women aged 50 and over in Dudley are socially isolated
  • Around 10,000 people aged 60 and over in Dudley say they feel lonely often
  • Loneliness is an important risk factor for early death and ill health
  • Participatory educational and social activity group interventions can help alleviate social isolation in older peoplee

 

There is limited evidence about what works in practice to increase social connectedness, however successful programmes tend to have the following features:

 

  • They are developed with older people participating in the planning, implementation and evaluation
  • They provide opportunities for older people to give as well as receive support
  • They use existing community resources and assets and aim to build community capacity
  • They provide social activity, have an educational or training element and are based on common interests in a group format
  • They target specific groups of older people for example with specific health conditions.

Recommendations

  1. Partners in Dudley should make tackling social isolation and loneliness in older people a priority and deliver a system wide approach to promoting social connectedness using the principles of understand, reach, develop and support.
  2.  Partners in Dudley should take every possible opportunity to present positive visible images of older people and the contribution they make to our community in their communications.
  3. Explore the development of a systematic method to indentify people across the borough whose loneliness puts them at a high risk of loss of independence and who consequently would benefit from more intensive support. This should include mechanisms to identify hidden carers.
  4. Use intelligence from the community asset mapping currently underway in Dudley to inform the development of local and community specific interventions to increase social connectedness, including facilitating relationships between the generations.
  5. Train front line staff from across partners and community champions in how to recognise the signs of loneliness and to enable them to signpost and refer for formal and informal support when necessary.
  6. Partners should identify and take up opportunities to build social connectedness into the way services are delivered including, for example, the development of community hubs and the new model of care.
  7. Partners should ensure that, as far as possible, older people are involved in the development of their services and programmes from the point of inception to delivery.
  8. Deliver a campaign to support older people to connect with their communities and encourage communities to be responsible, inclusive and aware of those who may be lonely.

References

  1. Council, M.C., 2009. Manchester: A Great Place to Grow Old 2010-2020. Manchester City Council.
  2. Jopling, K. 2015. Promising approaches to reducing loneliness and isolation in later life.  Pp. 68. Campaign to end Loneliness and Age UK.
  3. Devon County Council (no date) Time for life. Available at: http://www.timeforlife.org.uk/ (Accessed: 4 October 2016).
  4. Cheshire Fire and Rescue Service (no date) SPRINGBOARD. Available at: http://www.cheshirefire.gov.uk/partnerships/springboard (Accessed: 4 October 2016).

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